Shrinking eye - what can help to preserve eye health


Stepht
 

I will preface my question with an apology;  Katie’s CH is not updated. She is receiving 10 mg compounded pergolide which has kept her ACTH in the high teens to low 20s for almost 2 years.  Her ration is 15 lbs ODTB, 2 lb TC Sr, 2000 IUs vitamin E. This has been her ration for about a year. I will work to update CH with full details.

She was diagnosed with small cataracts 2 years ago.  In the last few months, her left eye vision seems to be deteriorating.  The vet said her eyeball appears to be shrinking probably due to her PPID.  Both eyes do have some cloudiness consistent with cataracts. Both pupils constrict significantly in the light. The right eye is a bit larger in the orbit than the left.

What at can I do to help minimize further deterioration and shrinking?  Would adding Vitamin A to her diet help?  Flax oil/omega 3?  (She does get flax oil or meal periodically, but she has “spells” when she will not eat well and if I remove the flax and salt she will return to eating.... we are in that cycle currently).   Has lutein been studied in horses?

Thank you!
--
Stephanie Thomson August 2, 2016

 

Liberty, Missouri

Katie Case History

Katie Photo Album  https://ecir.groups.io/g/CaseHistory/album?id=6072

Katie Lab Values Folder  https://ecir.groups.io/g/CaseHistory/files/Stephanie%20and%20Katie 


Sherry Morse
 

Hi Stephanie,

I'll be interested to hear Dr. Kellon's answer regarding the shrinking being due to PPID.  In my experience that kind of issue is usually caused by something like uveitis which we've discussed as being hard to control if PPID isn't controlled but that doesn't seem to be the case with Katie.

Regardless of that point though have you or your vet contacted the Vet Health Center at UM to see what they suggest for treatment of the cataracts at this point?




Frances C.
 

For the eye problem maybe EYEBRIGHT or bilberry extract may help
--
- Frances C.
December 2017, Washington & California
Case history: https://ecir.groups.io/g/CaseHistory/files/Frances%20and%20Phoenix
Phoenix's Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=12382


Stepht
 

Good suggestion!  I forgot about bilberry. 
--
Stephanie Thomson August 2, 2016

 

Liberty, Missouri

Katie Case History

Katie Photo Album  https://ecir.groups.io/g/CaseHistory/album?id=6072

Katie Lab Values Folder  https://ecir.groups.io/g/CaseHistory/files/Stephanie%20and%20Katie 


Stepht
 

No, we haven’t contacted MU.... which makes me wonder why we didn’t ?  I will check into this. Thanks!
--
Stephanie Thomson August 2, 2016

 

Liberty, Missouri

Katie Case History

Katie Photo Album  https://ecir.groups.io/g/CaseHistory/album?id=6072

Katie Lab Values Folder  https://ecir.groups.io/g/CaseHistory/files/Stephanie%20and%20Katie 


Joanne in CO 2020
 

Hi, I agree with Sherry.  I am an optometrist with 24 years experience with human eyes. If the eye is indeed shrinking (phthisis bulbi), that is usually due to a significant traumatic event or significant chronic inflammation, such as corneal degeneration, retinal detachment, and uveitis.  It is usually not DIRECTLY related to endocrine disorders. It can be indirectly related if the horse has uveitis from PPID. Are you sure the cloudiness is the cataract (which is the lens becoming cloudy), and not the cornea? Can you post a picture? 



Joanne, Colorado,  2020


Stepht
 

Hi Joanne,
the cloudiness appears to be “deeper” in the eye.  It does not look like the pictures of uveitis that I have seen where the cloudiness appears to be all over the surface.  Katie’s eye cloudiness resembles what I have seen in dogs with cataracts. I will get a picture posted of her eye. 

Is is it possible she has a sub clinical type of uveitis?

Would allergies cause enough inflammation to result in this kind of shrinkage?  In the summer she has puffy eyes often because of dust and flies. She wears a fly mask all day in the summer and I wipe her eyes with water or Vetricyn eye wash and that always helps. If that doesn’t control it, I give her spirulina and j- herb but I haven’t had to do that in a couple of years. Would it be reasonable to put her on these supplements year round to see what happens?

Thank you!
 
--
Stephanie Thomson August 2, 2016

 

Liberty, Missouri

Katie Case History

Katie Photo Album  https://ecir.groups.io/g/CaseHistory/album?id=6072

Katie Lab Values Folder  https://ecir.groups.io/g/CaseHistory/files/Stephanie%20and%20Katie 


Eleanor Kellon, VMD
 

This is not related to PPID and not related to inflammation unless you have had very obvious severe episodes of pain. We can't possibly get to the bottom of it here. You really need an ophthalmolgist.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Stepht
 

Thank you, Dr Kellon. I will make an appointment. It may take a couple of months though, so in the meantime would it be helpful to have bloodwork for inflammatory markers ie.... fibrinogen or C reactive protein?  Katie has not had any pain issues since March 2019 when she had an abscess. 

I have phots of her eyes I will get posted in her photo file. 


--
Stephanie Thomson August 2, 2016

 

Liberty, Missouri

Katie Case History

Katie Photo Album  https://ecir.groups.io/g/CaseHistory/album?id=6072

Katie Lab Values Folder  https://ecir.groups.io/g/CaseHistory/files/Stephanie%20and%20Katie 


Eleanor Kellon, VMD
 

Stephanie,

They won't be elevated with ocular disease https://pubmed.ncbi.nlm.nih.gov/21496078/
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Joanne in CO 2020
 

Glad you were able to get an appointment as it is difficult to get a definitive diagnosis without the aid of proper equipment & testing. These are my "observations", not "diagnoses", solely based on the pictures.  A "shrinking eyeball", called phthisis bulbi, is indeed known to develop in eyes experiencing a non-remitting inflammatory course. Your horses's eyeball does not have the appearance of a phthisis bulbi eye. Basically, a shrinking eyeball is a dying eye. All parts lose function, involving the cornea, which becomes opaque & smaller in diameter than the non-affected eye. Your horse's corneas look quite clear and of equal diameter. I see the right eyeball is in a more sunken position as compared to the left eyeball. This is called enophthalmos.  It can occur in elderly due to age-related fat atrophy behind the eye. It can also occur due to trauma causing changes to the eye's bony socket or surrounding sinus, or enophthalmos can be due to damage to the nerves affecting the extraocular muscles. Her right eyelid does not appear droopy and her pupils appear of equal size. These are good signs that help to rule out damage to the nerves that affect the extraocular muscles. Another good sign is full range of eye movement. It is still a good idea to see the vet to rule out some very rare but serious causes.  Also, I see signs of posterior synechia (iris stuck to her lens superiorly), in both eyes. This can occur from a past uveitic episode, in both eyes.  
Joanne, Colorado,  2020


Joanne in CO 2020
 

In summary, see the vet to rule out more serious causes. If it is due to senile fat atrophy or past trauma and vet simply wants to watch it, then also monitor her eye for dry eye since an enophthalmic eye tends to have dryness. You had asked about supportive supplements: artificial tears, increased water intake, omega-3 supplementation have all been shown by studies to help with dry eye.
--
Joanne, Colorado,  2020


Stepht
 

Hi Joanne,

thank you for taking the time to look at all of the photos and comment with your good information and advice!  I started her back on the flax seed oil and she has been eating well. Maybe it is my imagination, but her eyes seem brighter already!  I will post any info that I get from the vet. 


Thank you again!


--
Stephanie Thomson August 2, 2016

 

Liberty, Missouri

Katie Case History

Katie Photo Album  https://ecir.groups.io/g/CaseHistory/album?id=6072

Katie Lab Values Folder  https://ecir.groups.io/g/CaseHistory/files/Stephanie%20and%20Katie